Provider Demographics
NPI:1659895134
Name:INFINITY HOPE CENTER
Entity Type:Organization
Organization Name:INFINITY HOPE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARKITA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:833-422-4673
Mailing Address - Street 1:1759 WABASH ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1843
Mailing Address - Country:US
Mailing Address - Phone:833-422-4673
Mailing Address - Fax:313-486-1934
Practice Address - Street 1:277 GRATIOT AVE STE 100A8919
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-2239
Practice Address - Country:US
Practice Address - Phone:313-515-5145
Practice Address - Fax:341-331-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704218652363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty